Screening questionnaires

If you are showing the signs of sleep apnea, before getting more in-depth diagnostic tests, it is useful to assess your risk using some screening questionnaires.

Epworth Sleepiness Scale

Feeling excessively sleepy during the day is a key symptom of sleep apnea. Therefore, it is a good idea to measure your fatigue by using the Epworth Sleepiness Scale [1]. This questionnaire gives you a numerical score based on your self-assessed likelihood of falling asleep in certain scenarios. A score of sixteen or higher shows that you are very sleepy during the day.

STOP-Bang questionnaire

The STOP-Bang questionnaire [2] is the favored screening tool in the medical profession [3]. It is straightforward, highly effective and considers more than tiredness alone. It is a set of eight questions with yes/no answers in a handy acronym, where each letter refers to a sleep apnea risk factor:

Diagnosis

The Apnea-Hypopnea Index (AHI)

It is the purpose of a sleep study is to identify and quantify sleep apnea, giving you a severity score. This score depends on how many times you experience the characteristic low-oxygen events. The apnea-hypopnea index (AHI) is this measurement [4], counting how many times you are apneic or hypopneic in an hour:

Your AHI score relates to the severity of sleep apnea which is helpful when deciding how to treat it:

0-5 events per hour – normal

5-15 events per hour – mild sleep apnea

15-30 events per hour – moderate sleep apnea

30+ events per hour – severe sleep apnea

Polysomnography at a sleep clinic

Because snoring sound alone is not a reliable indicator of sleep apnea, other qualities need measuring too. This is done via a procedure is called polysomnography (poly = many, somnus = sleep, graph = drawing/measurements) and is usually conducted by a trained professional at a sleep clinic.

Sleep might not seem likely once you have been wired up and attached to the various monitors. But by observing eye movements, brain activity, muscle activation, airflow, oxygen levels and heart rate, you can construct a detailed image of what is happening to your body whilst you sleep, and gain insight into your sleep apnea.

Home tests

Although they are reliable, polysomnography tests in sleep clinics are impractical and expensive. Further, if you are lucky enough to get a referral for one, you’re likely to be waiting a while. Smaller scale tests done at home are therefore increasing in popularity.

Home testing uses portable devices with fewer parts, but importantly with enough measurements to get a good picture of your sleep apnea. Generally, they consist of:

If you are deemed to be at risk of sleep apnea, these kits can be supplied by your doctor. After performing the test at home, you return the kit for the results to be analyzed and a score to be generated.

Treating sleep apnea

The steps you take to improve your sleep apnea depend on the severity of your condition. If you suffer from mild to moderate sleep apnea, the techniques and consumer remedies you use to reduce normal snoring can still be very effective. Similar to so many other health issues, weight loss cannot be recommended enough.

If your condition is at the severe end of the scale, you are likely to be prescribed a device that keeps your airways open at night. This is called CPAP which stands for “continuous positive airway pressure”.

The device consists of a mask you fit over your face and an attached unit that draws in air. By introducing air into your throat and increasing air pressure, the soft parts of your throat are prevented from collapsing and causing obstruction.

Conclusion

If you’re a loud snorer and find yourself feeling sleepy throughout the day, you may be suffering from sleep apnea without even knowing it. Being aware of the signs and using questionnaires is useful to assess your risk, after which it might be a good idea to present to your doctor.

With in-depth sleep studies that can be done at a specialist clinic or at home, you make that important step away from the masses of un-diagnosed people to become someone who understands their condition and knows what to do about it.